Buffered prilocaine provided a longer postoperative pain-free period for patients undergoing surgical decompression of the median nerve. It is easy, safe, and cost-effective.
An extremely rare case of aggressive hydatid disease of bone is described in a 29-year-old male. Although the disease was limited to the talus at initial presentation, it spread through the entire foot and ankle after surgical treatment. The unusual aggressive nature of the recurrence was attributed to the spread of infestation during the first surgery. Amputation of the foot and ankle was performed due to the invasive nature of the bone and soft tissue involvement.
The prevalence of displaced acetabular fractures has increased with a substantial increase in traffic and the frequency of workplace accidents causing high-energy trauma. The treatment of these fractures is one of the complex fields of orthopedics, which is still developing (1). As with other intra-articular fractures, anatomic reduction of the load-bearing articular surface and rigid fixation are also essential in acetabular fractures. Without these, patients may develop post-traumatic arthrosis, and the hip joint movement may not start early even when proper treatment is given. However, acetabular fractures were often treated in the past conservatively. Because of the complexity of the region's and the difficulties encountered in reduction techniques, complications during and after the surgery and orthopedists' unfamiliarity of the surgical region have limited the surgical treatment of acetabulum fractures (2).
Despite optimal medical therapy patients with end-stage heart failure may deteriorate while waiting for cardiac transplantation. Bridging to transplantation with a ventricular assist device (VAD) may he a life saving procedure for these patients. We report our two cases who were implanted with MicroMed DeBakey VAD. Two male patients, 37 and 41 years old underwent implantation of a MicroMed DeBakey VAD as a bridge to heart transplantation. Both of them had end-stage left heart failure due to idiopathic cardiomyopathy and were listed for cardiac transplantation. Despite optimal medical therapy they developed acute hemodynamic deterioration. Both patients need inotropic support after implantation for adequate right heart function. The doses of the inotmpes tapered in a few days and then stopped. In the early phase after implantation, pump speed was not increased above 9,000 rpm to avoid excessive suction; but after that it was set between 9,000 and 11,000 rpm to achieve mixed venous oxygen saturation of 70% with mean arterial blood pressure more than 65 mmHg. For anticoagulation we started with intravenous heparin and then switched to warfarin sodium, clopidogrel bisulfate and acetyl salysilic acid orally. Both patients are still on the device after 46 and 25 days of uncomplicated pump support. In conclusion, these are first implants of the MicroMed DeBakey VAD in Turkey. From these cases we have learned that this device is appropriate for bridge to transplant purposes.
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